Locating and Paying Participants

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form 722 Financial Statement of Debtor	Form and Instruction	Unchanged	Available
Form Form 720CD Application for Lump-Sum Payment (child or dependent)	Form and Instruction	Unchanged	Available
Form Form 720 Application for Lump-Sum Payment	Form and Instruction	Unchanged	Available
Form Form 717 Benefit Inquiry Questionnaire	Form and Instruction	Unchanged	Available
Form Form 716A Certification of Pension Plan Disability Status	Form and Instruction	Unchanged	Available
Form Form 716 Certification of Social Security Disability Status	Form and Instruction	Unchanged	Available
Form Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only	Form and Instruction	Unchanged	Available
Form Form 710 Application for Electronic Direct Deposit	Form and Instruction	Unchanged	Available
Form Form 708 Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits)	Form and Instruction	Unchanged	Available
Form Form 707 Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits)	Form and Instruction	Unchanged	Available
Form Form 706 Beneficiary Application for Pension Benefits - OF	Form and Instruction	Unchanged	Available
Form Form 705 Beneficiary Application for Pension Benefits	Form and Instruction	Unchanged	Available
Form Form 702 General Information Form	Form and Instruction	Unchanged	Available
Form Form 701 Payee Information Form	Form and Instruction	Unchanged	Available
Form Form 700 Participant Application for Pension Benefits	Form and Instruction	Unchanged	Available
Form Form 721T Tax Election for Payment Not Eligible for Rollover	Form and Instruction	Unchanged	Available
Form Form 721 Application for Eligible Rollover Payment – Non-Spouse Beneficiary	Form and Instruction	Unchanged	Available
Form Form 720MP Application for Lump-Sum Payment	Form and Instruction	Unchanged	Available
Form Form 719 Election to Withhold Federal Income Tax from Periodic Payments	Form and Instruction	Unchanged	Available
Form Form 718 Installment Payment Agreement	Form and Instruction	Unchanged	Available
Form Form 715 Power of Attorney (POA)	Form and Instruction	Unchanged	Available
Form Form 714 Withdrawal of Employee Contributions – Non-Spouse Beneficiary	Form and Instruction	Unchanged	Available
Form Form 713 Election to Withdraw Employee Contributions	Form and Instruction	Unchanged	Available
Form Form 712 Uniformed Services Information Form	Form and Instruction	Unchanged	Available
Form Form 704 Report of Earnings and Social Security Disability Information	Form and Instruction	Unchanged	Available
Form Form 703RBB-MP Application for Elective Lump-Sum Payment, post RBD	Form and Instruction	Unchanged	Available
Form Form 703RBD Application for Elective Lump-Sum Payment, post RBD	Form and Instruction	Unchanged	Available
Form Form 703MP Application for Elective Lump-Sum Payment	Form and Instruction	Unchanged	Available
Form Form 703 Application for Elective Lump-Sum Payment	Form and Instruction	Unchanged	Available
Form Form 700RSC Election of Retroactive Annuity Starting Date (Spousal Consent Required)	Form and Instruction	Unchanged	Available
Form Form 700RN Election of Retroactive Annuity Starting Date (Spousal Consent not Required)	Form and Instruction	Unchanged	Available
Form MyPBA MyPBA Screen Shots	Form and Instruction	Unchanged	Available
Form MyPBA Locating and Paying Participants	Form and Instruction	Unchanged	Repair queued
Form720MP Final 08312024 - markup OMB 12202022.pdf	Supplementary Document	Uploaded 2022-12-20	Available
Form720MP Final 08312024 - markup OMB 12202022.pdf	Supplementary Document	Uploaded 2022-12-20	Repair queued
720 Clarifications for Roths - DRAFT for OMB submission 12202022v2 to OGC.pdf	Supplementary Document	Uploaded 2022-12-20	Available
720 Clarifications for Roths - DRAFT for OMB submission 12202022v2 to OGC.pdf	Supplementary Document	Uploaded 2022-12-20	Available
Form703MP final 08312024 - Roth simple 12202022 final for OMB.pdf	Supplementary Document	Uploaded 2022-12-20	Available
Form703MP final 08312024 - Roth simple 12202022 final for OMB.pdf	Supplementary Document	Uploaded 2022-12-20	Repair queued
703MP Clarifications for Roths - DRAFT for OMB submission 12202022v2 to OGC.pdf	Supplementary Document	Uploaded 2022-12-20	Available
703MP Clarifications for Roths - DRAFT for OMB submission 12202022v2 to OGC.pdf	Supplementary Document	Uploaded 2022-12-20	Repair queued
Justification-Rothclarification.d1.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-12-20	Available
Justification-Rothclarification.d1.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-12-20	Repair queued
Supporting statement paying and locating participants 2021.13.docx	Supporting Statement A	Uploaded 2021-07-07	Available
Supporting statement paying and locating participants 2021.13.docx	Supporting Statement A	Uploaded 2021-07-07	Available
Your Benefit Your Choice - 706V - July 2021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Available
Your Benefit Your Choice - 706V - July 2021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
Your Benefit Your Choice - 700V - July 2021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Available
Your Benefit Your Choice - 700V - July 2021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
Special Tax Notice 2019 update accepted all 05012019 - 07062021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Available
Special Tax Notice 2019 update accepted all 05012019 - 07062021 wtrmrked.pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
Acceptable Proofs of Age -2021.pdf	Supplementary Document	Uploaded 2021-07-07	Available
Acceptable Proofs of Age -2021.pdf	Supplementary Document	Uploaded 2021-07-07	Repair queued
700seriesCoverSheet PAN_and_PRA.01.docx	Supplementary Document	Uploaded 2021-07-06	Available
700seriesCoverSheet PAN_and_PRA.01.docx	Supplementary Document	Uploaded 2021-07-06	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Financial Statement of Debtor
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Lump-Sum Payment (child or dependent)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Benefit Inquiry Questionnaire
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Certification of Pension Plan Disability Status
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Certification of Social Security Disability Status
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Change of Beneficiary for Certain & Continuous (C&C) Benefits Only
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Electronic Direct Deposit
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Beneficiary Application for Pension Benefits - OF
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Beneficiary Application for Pension Benefits
13603	Locating and Paying Participants	Form and Instruction	Unchanged	General Information Form
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Payee Information Form
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Participant Application for Pension Benefits
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Tax Election for Payment Not Eligible for Rollover
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Eligible Rollover Payment – Non-Spouse Beneficiary
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Election to Withhold Federal Income Tax from Periodic Payments
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Installment Payment Agreement
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Power of Attorney (POA)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Withdrawal of Employee Contributions – Non-Spouse Beneficiary
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Election to Withdraw Employee Contributions
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Uniformed Services Information Form
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Report of Earnings and Social Security Disability Information
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Elective Lump-Sum Payment, post RBD
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Elective Lump-Sum Payment, post RBD
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Elective Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Application for Elective Lump-Sum Payment
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Election of Retroactive Annuity Starting Date (Spousal Consent Required)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	Election of Retroactive Annuity Starting Date (Spousal Consent not Required)
13603	Locating and Paying Participants	Form and Instruction	Unchanged	MyPBA Screen Shots
13603	Locating and Paying Participants	Form and Instruction	Unchanged

ICR Details

OMB Control No: 1212-0055	ICR Reference No: 202212-1212-002
Status: Historical Active	Previous ICR Reference No: 202107-1212-002
Agency/Subagency: PBGC	Agency Tracking No:
Title: Locating and Paying Participants
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/20/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2024	08/31/2024	08/31/2024
Responses	170,506	0	170,506
Time Burden (Hours)	58,376	0	58,376
Cost Burden (Dollars)	58,682	0	58,682

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Abstract: This collection consists of information participants and beneficiaries are asked to provide in connection with an application for benefits or request for a benefit estimate. In addition, in some instances, as part of a search for participants and beneficiaries who may be entitled to benefits, the PBGC requests individuals to provide identifying information that the individual would provide as part of an initial contact with the PBGC.

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Authorizing Statute(s): US Code: 29 USC 1322, 1350 Name of Law: Employee Retirement Security Act (ERISA)
   PL: Pub.L. 109 - 280 410 Name of Law: Pension Protection Act of 2006
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 13590	03/09/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 35838	07/07/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Locating and Paying Participants	Form 700RN, Form 700RSC, Form 703, Form 703MP, MyPBA, Form 703RBD, Form 703RBB-MP, Form 704, Form 712, Form 713, Form 714, Form 715, Form 718, Form 719, Form 720MP, Form 721, Form 721T, Form 706, Form 702, Form 707, Form 700, Form 701, Form 705, Form 708, Form 710, Form 711, Form 716, Form 716A, Form 717, Form 720, Form 720CD, Form 722	MyPBA Screen Shots ,   Election of Retroactive Annuity Starting Date (Spousal Consent not Required) ,   Election of Retroactive Annuity Starting Date (Spousal Consent Required) ,   Application for Elective Lump-Sum Payment ,   Application for Elective Lump-Sum Payment ,   Application for Elective Lump-Sum Payment, post RBD ,   Application for Elective Lump-Sum Payment, post RBD ,   Report of Earnings and Social Security Disability Information ,   Uniformed Services Information Form ,   Election to Withdraw Employee Contributions ,   Withdrawal of Employee Contributions – Non-Spouse Beneficiary ,   Power of Attorney (POA) ,   Installment Payment Agreement ,   Election to Withhold Federal Income Tax from Periodic Payments ,   Application for Lump-Sum Payment ,   Application for Eligible Rollover Payment – Non-Spouse Beneficiary ,   Tax Election for Payment Not Eligible for Rollover ,   Participant Application for Pension Benefits ,   Payee Information Form ,   General Information Form ,   Beneficiary Application for Pension Benefits ,   Beneficiary Application for Pension Benefits - OF ,   Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits) ,   Designation of Beneficiary for Benefits Owed at Death (Not Currently Receiving Pension Benefits) ,   Application for Electronic Direct Deposit ,   Change of Beneficiary for Certain & Continuous (C&C) Benefits Only ,   Certification of Social Security Disability Status ,   Certification of Pension Plan Disability Status ,   Benefit Inquiry Questionnaire ,   Application for Lump-Sum Payment ,   Application for Lump-Sum Payment (child or dependent) ,   Financial Statement of Debtor

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	170,506	170,506	0	0	0	0
Annual Time Burden (Hours)	58,376	58,376	0	0	0	0
Annual Cost Burden (Dollars)	58,682	58,682	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The reduction in burden is attributable to updated hour and cost burden estimates including the number of respondents (from 175,397 to 170,506) and the changes to this collection.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/20/2022

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